
<div class="panel panel-info">
	<div class="panel-heading">{{'PaymentSummary' | translate}}</div>
	<div class="panel-body">
		<form class="form-horizontal">
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="PaymentSummary.maxPaymentNumberAllowed"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.maxPaymentNumberAllowed" number disabled>
				</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="PaymentSummary.maxPaymentAmountAllowed"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.maxPaymentAmountAllowed" amount disabled>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="PaymentSummary.paymentNumberPolicy"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.paymentNumberPolicy" number disabled>
				</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="PaymentSummary.paymentAmountPolicy"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.paymentAmountPolicy" amount disabled>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="PaymentSummary.paymentNumberSinister"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.paymentNumberSinister" number disabled>
				</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="PaymentSummary.paymentAmountSinister"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.paymentAmountSinister" amount disabled>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 col-sm-offset-6 control-label" translate="PaymentSummary.estimatedPayedAmount"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="paymentSummary.estimatedPayedAmount" amount disabled>
				</div>
			</div>
		</form>
	</div>
</div>
